Neurology: More strengthening arm exercises may help stroke rehabilitation

The US Food and Drug Administration Bureau ( the FDA ) approved a new therapy requires evidence of clinical benefit of patients, using clinical endpoints sense to measure the patient's functional status or existence, that is, the ability to carry out daily activities.

Manage FDA

Trials of acute stroke treatment usually use the modified Rankin Scale (mRS) to assess benefit, which covers functional outcomes and is classified as a measure of activity restriction (previously called "disability") by the WHO International Classification of Functions (ICF).
It was accepted by the FDA as the primary endpoint of the acute stroke trial.
In fact, mRS is included in the definition of stroke disability jointly developed by the FDA.

Stroke

In contrast, trials of stroke rehabilitation therapy usually use indicators of body structure/function loss (previously called "injury") to assess benefits, such as the Fugl-Meyer (FM) exercise scale, and often do not even measure mRS.
The relationship between the improvement of body structure/function (such as the FM scale) and the measurement of activity restriction (such as mRS) is not always obvious, but a better understanding of the relationship between these two aspects may be useful for emerging stroke rehabilitation Treatment helps.

In order to solve this problem, Steven C.
Cramer of the University of California, Los Angeles, and others designed an intensive rehabilitation treatment test for the arm.
The main hypothesis: the improvement of body structure/function (FM score) may improve activity restriction (mRS score) .
In addition, the relationship between the improvement of mRS and the improvement of body structure/function was discussed from the change of FM total score and the level of specific sports injury.

The experiment included patients 90 days after stroke.
Each patient was evaluated before and 30 days after the 6-week routine rehabilitation exercise for the arm.
The increase in activity measured using mRS was compared with the increase in body structure/function measured using the Fugl-Meyer (FM) exercise scale.
In addition, it is also analyzed whether the increase in activity is more closely related to the increase in specific body structure/function.

Each patient was evaluated before and 30 days after the 6-week routine rehabilitation exercise for the arm.
Each patient was evaluated before and 30 days after the 6-week routine rehabilitation exercise for the arm.

They found that at baseline (160±48 days after stroke), patients (n=77) had a median mRS score of 3 (interquartile range, 2-3), which dropped to 2 (p< 0.
0001).

Similarly, the proportion of patients with mRS score ≤ 2 increased from 46.
8% at baseline to 66.
2% at 30 days after treatment (p = 0.
015).

Compared with those who did not have treatment-related improvements in mRS scores, their overall motor gain was similar (change in FM total score, p = 0.
63).

In addition, the improvement of specific dyskinesias, such as finger flexion and wrist circulation, is significantly related to the decrease in mRS.

The important significance of this research is that it was found that intensive arm rehabilitation therapy can improve mRS.
Focusing on specific movement disorders is a good rehabilitation therapy, thereby reducing activity restrictions.

It was found that intensive arm rehabilitation therapy can improve mRS.
Focusing on specific movement disorders is a good rehabilitation therapy, which can reduce activity restrictions.
It was found that intensive arm rehabilitation therapy can improve mRS.
Focusing on specific movement disorders is a good rehabilitation therapy, which can reduce activity restrictions.

Original Source: neurology.
org/content/96/14/e1812" target="_blank" rel="noopener">Intense Arm Rehabilitation Therapy Improves the Modified Rankin Scale Score

neurology.

neurology.
org/content/96/14/e1812" target="_blank" rel="noopener">Intense Arm Rehabilitation Therapy Improves the Modified Rankin Scale Score
neurology.
org/content/96/14/e1812" target="_blank" rel="noopener">Association Between Gains in Impairment and Function
neurology.
org/content/96/14/e1812" target="_blank" rel="noopener">Steven C.
Cramer, Vu Le, Jeffrey L.
Saver, Lucy Dodakian, et al.

neurology.
org/content/96/14/e1812" target="_blank" rel="noopener">Neurology Apr 2021, 96 (14) e1812-e1822; DOI: 10.
1212/WNL.
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